As one component of the NIH/DC Initiative to Reduce Infant Mortality a program of research addressing the threat of injuries and neglect to infants and toddlers in the District of Columbia has been developed. A comprehensive, city-wide injury surveillance system was established which collected data about injuries in children <3 years of age that resulted in an emergency room visit, hospitalization or death. Information about substantiated cases of abuse and neglect was also obtained from the Department of Family Services.Data collection is complete. Preliminary figures on accrual rates are available for all ten study hospitals. For September 16, 1995 through September 30, 1996, 3397 injury events were identified (3199 emergency department visits, 177 hospitalizations and 21 deaths). Rates of injury were highest in 12-23 month olds and lowest in infants <1 year of age. Both for hospitalizations and emergency department visits, the leading cause of injury was falls. Through the surveillance conducted at Family Services, 1398 eligible reports of substantiated abuse or neglect were identified. At three of the study sites a questionaire was administered to the parent or care giver shortly after the injury event. Interviews were completed for approximately 72% of the 2006 eligible cases, there were 43 refusals (2%), and the remaining interviews, 26% were closed for other reasons, e.g., invalid phone number or disconnected telephones. Current efforts are focused on the preparation of manuscripts for peer review.This study provides one of the first in-depth looks at non-fatal injuries in infants and toddlers. In addition, it demonstrates that multi- hospital surveillance is feasible and can provide population- based estimates of injury risk, thus identifying leading causes and high risk neighborhoods for targeted interventions. - Childhood injury, surveillance - Human Subjects